OUHSC Information Technology Department

Elevated VPN Request

This site is for requesting elevated VPN access to the Campus Network
A confirmation will be required before the request can be completed. Once confirmation is received the request should be completed as soon as it can be reviewed.

If you have any questions or comments please contact us by phone 271-2476, and leave a detailed message with your name and phone number. Someone will contact you as soon as possible.

This request should only be made by OUHSC Tier Ones.

Date VPN Access is needed: (The date should be in the following format: 12/01/2005)

Department Risk Analysis Completed?:


VPN User's Department: (Example: Medicine)

VPN User's Email: (john-smith@ouhsc.edu)

VPN User's Account Name: (Example: jsmith)

VPN User's Full Name: (Example: Smith, John A.)

Approving Authority: (Example: Immediate Supervisor's Full Name.)

Approving Authority's Email: (Example: john-smith@ouhsc.edu.)

VPN User's Internet Connection:

VPN User's Employment Title: (Examples: Physician, Accounting Staff)

Select VPN Level Required:

Justification For Elevated VPN Access: (Please describe below)


Your Email Address: (john-smith@ouhsc.edu)

Your Phone Number: (Phone, Cell or Ext.)

Your Full Name: (Smith, John C.)

Your Department or Organization: (Department or Organization)